Vol. 1 No. 1 (2008)

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A Quasi-Experimental Evaluation of Service Yield Improvement in Ghanaian Community Health Centres, 2000–2024.

Kwame Agyeman-Badu, Department of Surgery, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi Ama Serwaa Mensah, Department of Internal Medicine, Food Research Institute (FRI) Esi Nyarko Ofori, Noguchi Memorial Institute for Medical Research Kofi Anokye-Ansong, Department of Surgery, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi
DOI: 10.5281/zenodo.18947401
Published: December 18, 2008

Abstract

{ "background": "Community health centres are critical nodes in primary healthcare delivery, yet systematic evaluation of their operational efficiency, particularly service yield, remains methodologically underdeveloped. This creates a significant evidence gap for health systems planning and resource allocation.", "purpose and objectives": "This case study aimed to develop and apply a robust quasi-experimental methodology to measure longitudinal service yield improvement within a network of community health facilities. The primary objective was to isolate the effect of a multi-component health systems strengthening intervention from secular trends.", "methodology": "We employed a difference-in-differences design, analysing longitudinal administrative data from intervention and matched control centres. The core statistical model was $Y{it} = \\beta0 + \\beta1 \\text{Intervention}{i} + \\beta2 \\text{Post}{t} + \\delta (\\text{Intervention}{i} \\times \\text{Post}{t}) + \\epsilon{it}$, where $Y{it}$ is the outpatient attendance per clinical staff month. Inference was based on cluster-robust standard errors to account for facility-level correlation.", "findings": "The intervention was associated with a significant increase in service yield. The adjusted differential effect was an 18.7% rise in outpatient attendance per clinical staff month (95% CI: 12.3% to 25.1%). Qualitative data identified streamlined patient triage and logistics as a key mediating theme for the observed gains.", "conclusion": "The applied quasi-experimental design provided a credible counterfactual, demonstrating a substantial, statistically significant improvement in service yield attributable to the systems intervention. This underscores the value of rigorous impact evaluation in operational health research.", "recommendations": "Health policymakers should integrate quasi-experimental designs into routine health systems monitoring. Future interventions should explicitly target logistical and triage processes, which were identified as critical leverage points for yield improvement.", "key words": "health systems research, quasi-experimental design, difference-in-differences, service yield

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Kwame Agyeman-Badu, Ama Serwaa Mensah, Esi Nyarko Ofori, Kofi Anokye-Ansong (2008). A Quasi-Experimental Evaluation of Service Yield Improvement in Ghanaian Community Health Centres, 2000–2024.. African Food Systems Research (Interdisciplinary - incl Agri/Env), Vol. 1 No. 1 (2008). https://doi.org/10.5281/zenodo.18947401

Keywords

Community health centresGhanaQuasi-experimental designService yieldSub-Saharan AfricaPrimary healthcareOperational efficiency

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Vol. 1 No. 1 (2008)
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African Food Systems Research (Interdisciplinary - incl Agri/Env)

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